Many people considering laser eye surgery ask one simple, powerful question: will it hurt? The short, honest answer is that most patients do not experience severe pain during the procedure itself because local anaesthetic drops numb the eye, but sensations vary by the type of operation and during the first hours or first few days afterwards you can expect some discomfort. This article explains what to expect before, during and after common types of laser vision correction, compares LASIK, PRK and SMILE in terms of pain and recovery, and gives practical advice about managing any discomfort while stressing the importance of following your surgeon’s personalised instructions.
During modern laser eye surgery you will be awake but the eye surface is rendered numb with topical anaesthetic drops, so you should not feel sharp pain. Many people report that the most notable sensations are pressure, mild pulling or the awareness of the laser’s light, and sometimes a brief burning or stinging as the anaesthetic wears off. Surgeons usually offer a mild oral sedative if you are nervous, and an instrument will hold your eyelids open so you cannot blink during the brief treatment. The immediate intraoperative experience is generally tolerable and short-lived, with most procedures lasting only a few minutes per eye.
Once you leave the clinic the anaesthetic drops will fade and you may notice a range of sensations. It is common to feel grittiness, burning, watering and light sensitivity as the surface of the eye begins to settle. For LASIK these symptoms are often at their worst in the first few hours and then improve substantially over 24 to 48 hours. Surgeons commonly advise resting with closed eyes or taking a short nap immediately after the procedure to reduce discomfort and to let the eye begin its initial healing. If pain is intense or gets worse rather than better, contact your surgical team promptly as severe pain can be a sign of a complication that needs urgent assessment.
Not all laser procedures are the same when it comes to postoperative discomfort. LASIK is associated with a relatively quick recovery and limited pain because the corneal flap protects the eye surface during healing; most people describe only short-lived discomfort and a gritty feeling that eases within hours to a day. PRK involves removing the outer epithelial layer of the cornea, which regenerates over several days, and as a result PRK can produce more pronounced pain and foreign-body sensation for two to three days while the surface regenerates. SMILE is a newer keyhole technique that typically causes minimal pain comparable to or slightly less than LASIK, with many patients reporting only mild discomfort and rapid improvement. These differences are why surgeons recommend particular procedures for different corneal shapes, lifestyle requirements and tolerance for recovery.
The timeline for discomfort depends on the operation. For LASIK most patients feel substantially better within 24 to 48 hours and can resume most normal activities soon afterwards, although dry eyes and visual fluctuations can persist for weeks. For PRK, the worst pain is typically during the first 48 to 72 hours while the epithelium heals, and full visual recovery can take longer. For SMILE many people experience rapid improvement within the first day or two and report minimal downtime. Regardless of the technique, minor symptoms such as dryness, glare and soreness commonly improve over days to weeks and are managed with prescribed drops and follow-up care. If you experience severe or worsening pain at any point you must seek urgent review.
Topical anaesthetic eye drops are the mainstay of pain control during the operation and are highly effective at preventing intraoperative pain. After the operation your surgeon will usually provide or prescribe lubricating tears, anti-inflammatory drops and sometimes short-term oral pain relief for PRK patients or for those who report significant discomfort. In PRK, surgeons often fit a soft contact lens as a bandage to ease pain while the surface regenerates. Avoiding rubbing, using shields while sleeping if advised, and sticking to the drop regimen are simple but powerful ways to keep discomfort low and prevent complications. Always follow out-patient instructions precisely and ask for advice if over-the-counter painkillers do not control symptoms.
Most postoperative discomfort is expected and self-limiting, but some patterns should prompt immediate attention. Intense, worsening pain rather than gradual improvement, sudden loss of vision, new flashes or a shower of floaters, abnormal coloured discharge, or significant redness with a high temperature can indicate infection, inflammation, raised intraocular pressure or other complications that require urgent assessment. Your clinic should give clear instructions and an emergency contact number for after-hours concerns; do not hesitate to use it if you fear something is wrong. Early assessment and treatment greatly improve outcomes in the rare cases when complications arise.
Understanding what to expect reduces anxiety and makes physical sensations easier to cope with. Talk frankly with your surgeon about what you are likely to feel during and after the procedure, and ask for clear instructions about when to take painkillers and how to use eye drops. Arrange a calm, quiet place to rest for the first 24 hours, a friend or relative to accompany you to and from the clinic, and simple comforts such as sunglasses, a sleep mask and easy-to-prepare food. Planning practical details ahead of time so you can relax after the operation removes many small sources of stress that can amplify discomfort.
Pain tolerance varies widely between individuals and is influenced by anxiety, previous experiences, ocular surface disease, contact lens wear history and the precise surgical technique chosen. If you suffer from dry eye, blepharitis or autoimmune conditions that affect healing, discuss these with your surgeon before the operation as they can increase postoperative discomfort and extend recovery. Similarly, patients who are prone to motion sickness or who have particular occupational needs should explain their circumstances so a tailored plan can be made. Your clinical team will aim to match the procedure to your eyes and lifestyle to achieve the best balance of comfort and outcome.
In the immediate days following surgery follow the aftercare plan your surgeon provides. Protect your eyes from rubbing and avoid environments that increase infection risk such as swimming pools or dusty work sites. Use prescribed drops on the schedule given, rest when advised and protect your eyes from bright light with sunglasses. If you have PRK, anticipate the most discomfort in the initial two to three days and ensure you have adequate pain relief at home and someone to help you if needed. Keep emergency contact details to hand and do not introduce any unprescribed eye products as these can interfere with healing.
While the prospect of eye surgery can be daunting, advances in technique and anaesthesia mean that for most people the procedure is far less painful than they expect and the benefits in vision improvement are considerable. LASIK and SMILE are generally associated with mild and brief discomfort, and PRK can cause more significant pain during the early healing window but is managed effectively by modern protocols. The best way to be confident is to have a detailed consultation with a qualified refractive surgeon who can assess your eyes, explain which procedure is most suitable, outline expected sensations and recovery for your circumstances, and give you practical plans for pain management.